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HomeMy WebLinkAboutBuilding Permit 13. 0530 A' a 1 a YA'' F f 'a f "' ..il,ut,. 1_. __ i,_ri r_.i ci i,_, , .. ., _. rt fifi xa fr of Mtrupattxv ;,• CITY OF PRIG R LAKE Prparftttruf of ntDnnn cIu pi tfton . d Final Permitted ❑ Conditional C.O. Expires This Certificate i ssue d pursuant to the requirements of Section 110 of the ❑ Res idential / ❑ I ? Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior Lake regulating building construction or use. For the following: Use Classification SINGLE FAMILY Bldg. Permit No. 1 3-053n Occupancy Type Type Construction Zoning District PUSD Legal Description Ifs i 1, , I F F F F R S W A T E R F RO N T 1 PARKS I DE COURT Owner of Building Site Address Contractor's Name & Address r ' j A T !AMY HOMES i s ROBERT n, HUTCHINS City Planner * Date: I r r Building Official Date :'' POST IN CONSPICUOUS PLACE .0 >, ?1 A it u; a • n l .. .I f11 : A9, t 4 .., M a i .. n i ��.i l u i ill 4� % I �I A ' . 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O. u. tl ° J cc w I I - L. • 0 Z V 0 iza g r z c, S aZ O z 0 to — H 0 ^ 0 W F- uu_ N _ �z S g r co 0 re o< o Ow W w z OO a / 1h_ � 0 0 0 v V D. 8 2 u. u. u. 3 u. Vf 3 V 0 & \f 1.11 Y V1' YK1VK LAM, 13L1LD1_�Il.r Y1':K.Y111, j 1 _ L'WE � ■ .'C'd L� v � TEMPORARY CERTIFICATE OF ZONING CONIPLI_ ' - .E ND UTILITY CONNECTION ER�'IIT I MAY - 3 2013 1:vvE M al k el Fi 71 Pink City P E ol� * �� li S ,t . Pnk Cty r 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS i t-}3 p] P ts,,i '-S ( D E. c_ ZONING (office use) P451) LEG AL DESCRIPTION (office use only) I / LOTro 1 BLOCK l ADDITION CA e- �-S k./k >z r2.4) ^n PID 2 - 51 41$0(.1 p OWNER NER (Name) i'l p.--c T p... M -e 44 U t"I as (Phone) (Address) 12a l IN A S 14 I r-1 b A v S Sit= 20 ( t .O I r..l F I-I N S S 43 9 BUILDER (Company Name) M t\T Thrt-v 4+0 ES (Phone) (Contact Name) S 0 l= BA'c, (Phone) (Address) 1 t t"-, Pc S E-} li■I (,. t....) ! vs_ S 5'1— 2_4) t 1= I tom! t H 1...1 SSA 3, TYPE OF WORK New Construction gDeck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ['Addition ['Alteration ['Utility Connection CODE: iii' .R.C. ❑I.B.C. ❑ Misc: Type of onstruction: I II III IV V A 13 Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 1 i f 0 t 00 0 - 06 Division: 1 2 3 4 5 (excluding land) I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above - mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X(11), C... .-........---e_____,. BL '3 - , 532)b s 12_1 ►3 Signature Contractor's License No. Date Permit Valuation � - Park Support Fee # $ Permit Fee $ 7:5-9- 7 /1/07. - � SAC # 5 Plan Check Fee $ q, 1 )_ ' � Water Meter Size 5/8"; 1 "; $ gfgt:), Dd State Surcharge $ ,7q SO Pressure Reducer $ /20. 0 0 Penalty $ A _._____ Sewer /Water Connection Fee # $ DQ Plumbing Permit Fee $ /5 S - z Water Tower Fee # $ /POO V Mechanical Permit Fee $ /59, SO Builder's Deposit $ S -� 6 _ DO Sewer & Water Permit Fee $ 7 Oth er $ �� S"D - ir-e -) 9 y 49)--) /.5 SD Gas Fireplace Permit Fee $ , i a TOTAL DUE $ 'i 0 / r - 30 C, t Paid //, d (3 RecO.7 l,� 4 / / ..O BeCOnaeSYOUrBUildiflPermitWheflAPPrOVed Date / / 3 i By B T ing Official ate This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 4474245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 . ir"e ..410 t11. ; :Ns >4)c Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the Job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: JEFFERS POND DATE /o - - //— '? PROPERTY ADDRESS: 14307 PARKSIDE COURT "WILLOWBROOK" ACCEPTED BY APPROVING AUTHORITIES: CITY OF PRIOR LAKE ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES ONO EQUIPMENT USED IS APPROVED EVES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS BYES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: OYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS YES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS BYES ONO 3. NFPA 25 EYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2013 1/2 11 155 SPRINKLERS RELIABLE RES44HSW 2013 1/2 15 155 RELIABLE F3QR 2013 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR - ..5 43 DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION* PRESSURE PRESSURE AIR PRESSURE TEST OUTLET* PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/O Q.O.D. WITH Q.O.D. IF NO, EXPLAIN LOCATION MAKE & SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE & FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A OPERATION: ❑PNEUMATIC El ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES O NO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES ONO CONTROL. STATIONS DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES O NO N/A MAKF MODFL D SS E P RVIRInN , R 1 O Al ARM fPFF F E VA VP RFI FA OP MAXIMUM ATF RFI FAS YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 bars) for two hours of 50 psi (3.4 bars) above static pressure in excess of 150 psi (10.2 bars) for two hours. Differential dry -pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC; Establish 40 psi (2.7 bars) air pressure and measure drop, which shall not exceed 1 -1/2 psi pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed (0.1 -/b ars) in hours. t psi (0.1 1 bars) in 24 4 h hours. ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR .. HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES 'ENO EQUIPMENT OPERATES PROPERLY YES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SIUCATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? ®YES NO DRAIN READING OF GAGE LOCATEQ N R WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION PSI CONNECTION OPEN WIDE i PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 858 OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND I SPRINKLER PIPING YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN YES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED I LOCATIONS I GASKETS 0 NUMBER REMOVED WELDED PIPING OYES ®NO IF YFR DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS 010.9, LEVEL AR -3? BYES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUAUFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3 YES ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? OYES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA EWES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: / 0,.. //-. / 3 NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC. TEST WITNESSED BY FOR " i O'E' A • NER (SIGNED) _ T E DATE SIGNATURES X ` R` . ,.. •R SP'IN ER CONT � ���a2 r r� �� i 0 ) TITLE DATE O uv . t,t.4., . lU / ( -!3 ADDITIONAL EXPLANATION AND NOTES pi P.1/04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd ti TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 4 N ss °� N 1. wink Fite 2. Pink City PERMIT NO. 13 • 5 3. Yellow Applicant (Please type or print and sign at bottom) C ZONING (office use) ADD C' p, 0_46 t 0!✓ �u Z.T NW 4/ W i t-Low 6 4 I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) i ta11aAY ACP i.A.0 (Phone) g5Z'217— Zt c o (Address) 720 61115 t-(t loT°' IAA ' 61) itJA , MN 554- 1 (C o om m pp an n yy Name) "P",12.6 >P P E8. E1 3 Sf T J V ES t (--L -C (Phone) 7 lip -277 - 0 0 (Contact Name) _J A 5 °1J l �A.N.iT_ IZ (Phone) (Address ) /1110 Tn ,n tJsmt4� al et.t� I�c Sv 1 TE N 6 1, ue"E , 1---iNi 55330 TYPE OF WORK New ion �Construction ODeck �UOP Connecn❑Re- Roofing DRe- Siding ['Lower Level Finish ❑ Fireplace CODE: TgI.R.C. DLB•C. 0 Misc. Type of Construction: A B E E H I V �� %� S U PROJECT COST /VALUE $ ` 00 Divv upan D Group: 1 2 t) 4 5 (excluding land) ision: : I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the above - mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official ca ev oke this pemtit r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. C-- —145 8 _2t►_ �3 X ,,„ 41 Contractor's License No. Date Signature Park Support Fee # $ Permit Valuation ©pp • 6 O # $ Permit Fee $ (03. OO SAC Plan Check Fee , $ 69 a 5 " Water Meter Size 5/8 "; 1 "; $ l0 i $ State Surcharge $ 2 . c Pressure Reducer Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE „ - Yo Building P 't When Approved Paid I Receipt No. Ai I Date B b 44CC IF ' is uil . F g 0 gcial ate ����� 6 / This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning p itrinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 Oe.c E* I1 • t 04 P RIO CITY OF PRIOR LAKE Date Reed � - e HEATING /AIR CONDITIONING/FIREPLACE PERMIT S iitvsot t 1 yak Pik PERMIT NO. /3 _ D�r3 D 2. Gees City 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) c 76` r l g`— (Address)7 , iJ. -; , fir 4 S iitLA.44 y APPLICANT HEARTH & HOME TECHNOLOGIE (Name) dba FIRESIDE HEARTH & HOMrhone) Lic 662656 • (Address) 2700 FAIRVIEW AVENUE N (Address) ROSEVILLE, MN 55113 (City) (Zip Code) (Contact Person) PC14 651.63 3.2561 (Phone) . APPLICANT SIGNATURE �J' DATE c ic r Z3 . " --1 3 APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS • FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT . TYPE OF SYSTEM HEATING OR POWER PLANT . ❑Warm Air Plants PLEASE NOTE: Air Conditioner ❑ Steam Units and Fireplaces Cannot Encroach • 'ty ❑ Hot Water into Required Side Yard Setbacks. echanical ❑ Radiation • Air Conditioning ❑ Special Devices Fireplaces with Box Additions or :Went System 0 Other Devices Cantilevers to the Outside of Buildings • Require a Building Permit. FIREPLACE MAKE AND MODEL ff 'nil SL 7t. ltd . 1 2yt1 q7 FEE SCHEDULE Industrial, Cotnmereial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50 • $49.50 minimum 1 WITH Residential, Heating & A/C (New Construction) $14930 Residential, Additions & Alterati A1I� 1!V 1TH $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only BUILDING PER11 P#° . Estimated Cost $ 100, Bo Building Permit # I 1 The Minnesota Statutes § 326E3.148 . HEATING PERMIT FEE $ "SURCHARGE" IAAR( a has been changed For one Year effective STATE SURCHARGE $ .50 July I.2010, until June 30. 2011. TOTAL PERMIT FEE $ The minimum surcharge for a "fixed fec" permit (Office Use Onty) is IS beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Bulldine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 . From:Genz-Ryan 952 767 1900 09/10/2013 13:53 #596 P.001 /0 4 PRIG Date Rec'd 0, `j C ITY OF PRIOR LAKE PLUMBING PERMIT 4747v>as0° '• ewa �l� PE RMIT NO. s. aara cny � ) 3. Mow APpricam � _....� / i �-/ (Please type or print and sign at bottom) f V ( /'� ADDRESS ZONING ZONING (otrloe use) /'136 9-Lrsid �' / ; _ ..,2)4./s,6 LEGAL DESCRIPTION (office use only) LOT (v &BLOCK 1 ADDMONJe r--/s / 4/% /•i1/ PIn •?S y ®/ (Name) J ed( •� .fC`1 ' /._.1, GL. ) Cam- (Phone) (Address) — APPLICANT APPLICANT (Name) GENZ RYAN (Phone) 952-767-1000 (Address) 2200 W HIGHWAY 13 - �� BURNSVILLE 55337 (Address) (City) (Zip Code) (Contact Person) LONI PETERSON (Phone) 952 - 767 -1000 APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Ran , h -ins / Dishwasher / Water Heater / Floor Drain Water Softener _ Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) f Laundry Tray (1 or 2 compartment sink Sewage Ejector .2 Shower Stall Backflow Assembly _� / Sinks Backflow Assembly Test —_ Bar Sink Lawn Sprinkler ;, 3 Water Closet (Toilet) / Other d fir? �' uc , yc e FEE SCHEDULE ',� Industrial, Commercial & Multi- family 1% of job cost with a 549.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 Est $ `4 — The Minnesota Statutes ii 3260.148 I ! tJ 1 Building Permit # "SURCHARGE" has been changed for one PLUMBING PERMIT FEE $ /I/90 60 • July i1, 2410, year l Ju ne until 30, 2011. STATE SURCHARGE $ v © CSB. The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ t' y/, 50 is Al beginning duty 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. _._ . PAID . _ Daze BUILDING PERMIT Building Official Dal! 24 hour notice for all inspections (952) 447 -9850, fax (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 .. From:Genz -Ryan 952 767 1900 09/10/2013 13:53 #596 P.002/0 &‘7 I I t vitro CITY OF PRIOR LAKE Date Recd „,, t o fi HEATING /AIR CONDITIONING/FIREPLACE PERMIT q . 10, )3 ' 4Q1vNEsoo 2. 1, pGruinen PA; Piir ry PERMIT NO. tJ 2 / M a 1. Yrllaw Applicrti (Please type or print and sign at bottom) ADDRESS Z ONING (otscc ) �7 1 r e vV phis. LEGAL DESCRIPT ION (office use only) /J LO' ✓ 0 BLOCK ( / ADDITION le •f / ` { /' tilt t-L f� bbl / PID Z5 - Cr7g O OW , :4410 f /..4... t -- M e G . (Name) (Phone) , / ' (Address) APPLICANT (Name) GENZ RYAN (Phone) 952-767-1000 (Address) 2200 W HWY 13 BURNS'V'ILLE 55337 ' (Address) (City) (Zip Code) (Contact Person) LONI P �TERS6N j (Phone) 952-767-1000 APPLICANT SIGNA 111 g ..t ..y- • f = ! I , r DATE c, `/d ..-/ 3 APPLICANT PLEASE COMPLETE BELOW *NEW CONSTRUCTION ❑ REPLACEMENT 0 ALTERATIONS • FURNACE MAKE AND MODEL # ' 9/ 8 / 7 FUEL iV� L. FLUE SIZE R 't OPENINGS e INPUT 6- ouTPUT5 ' D 0 TYPE OF SYSTEM BEATING OR POWER PLANT [Warm Air Plants Steam PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach ■ Gravity 0 Hot water ... °chanical 0 Radiation into Required Side Yard Setbacks. 'f it Conditioning [] Special Devices Fireplaces with Box Additions or 4ent. System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi - Family I% of job cost . Residential, Gas Fireplace • $49.50 549.50 minimum Residential, Heating & A/C (New Construction) 5149.50 Residential, Additions & Alterations 549.50 Residential, Heating Only (New Construction) 564.50 Residential, AC Only 549.50 r / cif Estimated Cost $ 90 Building Permit #_ _ J "Else Minnesota Statutes * 32613.148 HEATING PERMIT FEE $ _ /03 6 "SURCHARGE'," has hecn changed for one year elective STATE SURCHARGE $ `© .69 July 1. 2010, until June 30. 201 TOTAL PERIVI.I;T FEE $ /SW, .5, The minimum surcharge rnr a "fired fee" permit (Office Use Only) is IS beginning July 1.2010 This Application Becomes Your Building Permit When Approved Paid c i PAt IH Date RA DOS. OS. PFB!1PT Building Official Date • 24 hour notice for all Inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 1 Sul Depost i i, � fi . City of Prior Lake A $2,500.00 Builders Deposit is included hi the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 130 days after the date the building permit is issued. If the work is not complete within the 130 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $2,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective vvcrk to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: S 19---1) 3 SITE ADDRESS: 1 .4 01 Pc\-v--st o C'a- PERMIT # 1 3` � 3t) REFUND TO BE MAILED TO: ;'la t> rl 44 ot-t es 1 2-o ( bvA5 tit tN610 i.v S, S u di $- 201 e-D Its) A , r-tr.l SS&43 PLEASE ItEMEMBEP. 1. KEEP STREETS CLEAN DURING CONSTRUCTION 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT P1UST NOT EXPIRE OR $500.00 WILL BE FORFEITED SIGNATURE: CSh.' /y I' Wiz, Sov . vo Lynda S. len, Building Services Amount /U , z/ • 43 _ Acct. 801.20204 Date J:\FORMSIBUILDERS DEPOSIT FORM.DOC PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS /4007 / S &V L ' NATURE N� ern EOFWORK $'4 Nd Pate USE OF BUILDIN _ %/i ce / ` , W ‘E - , PERMIT NO. Alr--s 3 o DA SSUED CONTRACTOR P///-7771-1-1./ PHONE INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE FOOTING t: _ 0 _ ,_ FOUNDATION (Prior To Backfill) RADON RETARDER PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER/WATER/SEPTIC FRAMING wL �ij INSULATION „ 0 r ELECTRICAL PLUMBING , HEATING P6 9 FIREPLACE GAS LINE AIR TEST RADON-RETARDER U` (9A 71 �� COVER NO WORK UNTIL THE ABOVE HAS BEEN SIG ED (HOUSEWRAP LATH J 1 1. FINALS F,a& rjvpp2rs3s,.uv 10 /r 3 GRADING ( RIOR TO SODDING) BUILDING ELECTRICAL PL' UMBING 12 •4 . io l I 1/3 _ HEATING 1 DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough -in inspections and maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447 -9850